• Care of the stroke patient-communication between the community pharmacist and prescribers in the Republic of Ireland.

      Grimes, Tamasine; Duggan, Catherine; Gallagher, Paul; Strawbridge, Judith; Adelaide and Meath Hospital, incorporating the National Children's Hospital,, Dublin 24, Ireland. tgrimes@rcsi.ie (2012-02-01)
      OBJECTIVE: This study sought to examine the perceptions that community pharmacists have of communication with prescribers in both primary and secondary care in Ireland, with respect to care of stroke patients. SETTING: Community pharmacies across Ireland, stratified into the four representative administrative regions. METHOD: Survey using a structured postal questionnaire. MAIN OUTCOME MEASURE: Perceptions of communication with prescribers based in primary and secondary care; pharmacy and pharmacy premises demographics. RESULTS: A response rate of 52% (n = 314) was achieved. Community pharmacists' perceptions of information provision from secondary care were low, the majority (83%) never received any information from the hospital, although they would welcome it. Communication with hospital based prescribers was considered by most (93%) to be poor. The majority (greater than 75%) of respondents expressed a desire for greater information provision concerning a stroke patient's medication and diagnostic information. Pharmacists' perceptions of interaction with general practitioners were generally regarded as good (63%) although information provision in both directions between pharmacist and general practitioner could be improved. CONCLUSION: The findings of this study indicated that community pharmacists perceive that there is room for improvement in the communication between themselves and prescribers in the primary and secondary care settings, concerning the care of the stroke patient. This highlights the need for the development of formal communication channels between community pharmacists and other members of the healthcare team involved in the care of the stroke patient. However, the challenges of communicating patient information across healthcare sectors are recognized.
    • Current state of musculoskeletal ultrasound training and implementation in Europe: results of a survey of experts and scientific societies.

      Naredo, Esperanza; D'Agostino, Maria A; Conaghan, Philip G; Backhaus, Marina; Balint, Peter; Bruyn, George A W; Filippucci, Emilio; Grassi, Walter; Hammer, Hilde B; Iagnocco, Annamaria; et al. (Rheumatology (Oxford, England), 2010-12)
      To document the current state of musculoskeletal US (MSUS) training and extent of implementation among rheumatologists in the member countries of EULAR.
    • A health and safety survey of Irish funeral industry workers.

      Kelly, N; Reid, A; Occupational Health Unit, The Adelaide and Meath Hospital, incorporating the, National Children's Hospital, Dublin 24, Ireland. nualakelly@physicians.ie (2012-02-01)
      BACKGROUND: Those handling deceased individuals, including the funeral industry, face a variety of health and safety hazards including occupationally acquired infectious disease. AIMS: To identify the knowledge, attitudes and beliefs of Irish funeral industry workers towards occupational hazards and infectious disease in 2009. METHODS: The sample analysed consisted of all listed member premises of the Irish Association of Funeral Directors as at 1 July 2009. A postal survey was sent to each premises in July 2009, with two rounds of follow-up reviews sent to non-responders. Four main areas were covered--occupational hazards, embalming, industry expertise and demographics. The quantitative and qualitative results were analysed to assess knowledge, attitudes and beliefs. Data collection was completed on 31 December 2009. RESULTS: Two hundred and thirty listed member premises were contacted. Twenty-two were unsuitable for the survey. One hundred and thirty-eight valid replies were received from 130 premises, representing a premises response rate of 63% (130/208). Seventy-three premises (56%) identified themselves as embalmers. Embalmers had variable vaccine uptake and variable knowledge, attitude and beliefs towards embalming those with blood-borne viruses. Fifteen per cent of respondents reported a work-related injury, back injury being the most common. Splash and sharps injuries were reported as a work-related injury, and infections believed to be work related were also reported. CONCLUSIONS: This study demonstrates widespread occupational health concerns among this professional group. It confirms the need for occupational health advice and services. There is also a strong desire for regulation of this profession in Ireland.
    • Inappropriate colonoscopic surveillance of hyperplastic polyps.

      Keane, R A; O'Connor, A; Ryan, B; Breslin, N; O'Connor, H J; Qasim, A; O'Morain, C; AMNCH, Tallaght, Dublin 24. rukeane@tcd.ie (2011-11-15)
      Colonoscopic surveillance of hyperplastic polyps alone is controversial and may be inappropriate. The colonoscopy surveillance register at a university teaching hospital was audited to determine the extent of such hyperplastic polyp surveillance. The surveillance endoscopy records were reviewed, those patients with hyperplastic polyps were identified, their clinical records were examined and contact was made with each patient. Of the 483 patients undergoing surveillance for colonic polyps 113 (23%) had hyperplastic polyps alone on last colonoscopy. 104 patients remained after exclusion of those under appropriate surveillance. 87 of the 104 patients (84%) were successfully contacted. 37 patients (8%) were under appropriate colonoscopic surveillance for a significant family history of colorectal carcinoma. 50 (10%) patients with hyperplastic polyps alone and no other clinical indication for colonoscopic surveillance were booked for follow up colonoscopy. This represents not only a budgetary but more importantly a clinical opportunity cost the removal of which could liberate valuable colonoscopy time for more appropriate indications.
    • Obesity in Ireland in 2008: what radiological equipment is available to image the obese patient?

      Campbell, N; Buckley, O; McGlone, B; O'Shea, D; Torreggiani, W C; Weight Management Service and Department of Radiology, St Columcille's Hospital, Loughlinstown, Co Dublin. naomicampbell28@hotmail.com (Irish medical journal, 2009-04)
      Obesity is a global epidemic, responsible for 2000 premature deaths in Ireland each year. The extent of this epidemic was quantified by the National Taskforce on Obesity (IOTF), whose report, published in 2005, found that 39% of adults in Ireland were overweight and 18% obese with obesity in adults predicted to increase by 1% per year. In light of the clear evidence that we, as a nation, are quite literally expanding, how well equipped are Irish hospitals and, in particular, radiology departments, to deal with patients of increasing size and weight? The purpose of this study was to quantify the weight limits and girth restrictions of the radiology equipment, in particular CT, MRI and fluoroscopy, in hospitals, both public and private, in Ireland in an attempt to answer this question.
    • Prevalence of psoriasis in patients with alcoholic liver disease.

      Tobin, A M; Higgins, E M; Norris, S; Kirby, B; Department of Dermatology, Adelaide and Meath Hospital Incorporating the National, Children's Hospital, Tallaght, Dublin, Ireland. (2012-02-01)
      BACKGROUND: Excessive alcohol use has been implicated as a risk factor in the development of psoriasis, particularly in men. Despite this, little is known of the incidence or prevalence of psoriasis in patients who misuse alcohol. OBJECTIVE: To assess the prevalence of psoriasis in patients with alcoholic liver disease. METHODS: In total, 100 patients with proven alcoholic liver disease were surveyed for a history of psoriasis and a full skin examination was performed if relevant. RESULTS: Of the 100 patients, 15 reported a history of psoriasis and another 8 had evidence of current activity, suggesting a prevalence (past or present) of 15% in this group of patients. CONCLUSION: It would appear that the prevalence of psoriasis in patients who misuse alcohol is much higher than the 1-3% variously quoted in the general population.
    • Prospective randomised controlled trial comparing trigone-sparing versus trigone-including intradetrusor injection of abobotulinumtoxinA for refractory idiopathic detrusor overactivity.

      Manecksha, Rustom P; Cullen, Ivor M; Ahmad, Sarfraz; McNeill, Graeme; Flynn, Robert; McDermott, Thomas E D; Grainger, Ronald; Thornhill, John A; Department of Urology, Adelaide & Meath Hospital, Dublin, Ireland. rustom.manecksha@gmail.com (2012-05)
      Botulinum toxin A is effective for treatment of idiopathic detrusor overactivity (IDO). The trigone is generally spared because of the theoretical risk of vesicoureteric reflux (VUR), although studies assessing injection sites are lacking.
    • Public awareness of testis cancer and the prevalence of testicular self-examination-changing patterns over 20 years.

      Casey, Rowan G; Grainger, Ronald; Butler, Michael R; McDermott, Thomas E; Thornhill, John A; Adelaide and Meath Hospital Dublin, Incorporating the National Children's, Hospital, (AMNCH), Tallaght, Dublin, Ireland. (2012-02-01)
      OBJECTIVES: Delay in treatment of testis cancer (TC) has a proven negative impact on disease stage, treatment outcome, and mortality. Poor public awareness of the disease and lack of testis self-examination (TSE) may account for late presentation. The aim of this study was to examine the knowledge of TC and performance of TSE in a group of men over 2 time periods 20 years apart. METHODS: In the current study, 677 men from a banking institution were surveyed on their knowledge of TC and their performance of TSE. Comparisons were made from the current data and those from the original study in 1986. RESULTS: This study demonstrates an increase in public awareness and modest concomitant increase in TSE since first studied in this country in 1986. There was no difference in knowledge across age groups in this study. Furthermore, men who demonstrate a superior degree of knowledge were more likely to perform TSE. Limitations included possible selection bias in the 2 studies conducted in a banking institution. CONCLUSIONS: Increased testicular cancer knowledge combined with TSE may have a role in improving detection of significant testicular pathology.
    • A randomized, double-blind, controlled study of ultrasound-guided corticosteroid injection into the joint of patients with inflammatory arthritis.

      Cunnington, Joanna; Marshall, Nicola; Hide, Geoff; Bracewell, Claire; Isaacs, John; Platt, Philip; Kane, David; Freeman Hospital and Newcastle University, Newcastle upon Tyne, UK. (Arthritis and rheumatism, 2010-07)
      Most corticosteroid injections into the joint are guided by the clinical examination (CE), but up to 70% are inaccurately placed, which may contribute to an inadequate response. The aim of this study was to investigate whether ultrasound (US) guidance improves the accuracy and clinical outcome of joint injections as compared with CE guidance in patients with inflammatory arthritis.
    • Renal transplantation in systemic vasculitis: when is it safe?

      Little, Mark A; Hassan, Basma; Jacques, Steve; Game, David; Salisbury, Emma; Courtney, Aisling E; Brown, Catherine; Salama, Alan D; Harper, Lorraine; Renal Institute of Birmingham, School of Immunity, Infection and Inflammation, University of Birmingham, Birmingham, UK. (Nephrology, dialysis, transplantation : official publication of the European, 2009-10)
      There are no clear guidelines on renal transplantation in patients with antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis.
    • Small bowel angiodysplasia and novel disease associations: a cohort study.

      Holleran, Grainne; Hall, Barry; Hussey, Mary; McNamara, Deirdre; Department of Clinical Medicine, Adelaide and Meath Hospital, Trinity College Dublin, Dublin, Ireland. grainneholleran@gmail.com (2013-04)
      Gastrointestinal angiodysplasias recurrently bleed, accounting for 3-5% of obscure gastrointestinal bleeding. The advent of small bowel capsule endoscopy (SBCE) has led to an increased recognition of small bowel angiodysplasias (SBAs) but little is known about their etiology. Previous small cohorts and case reports suggest an equal gender incidence and associations with cardiovascular disease, renal impairment, and coagulopathies.
    • A survey of patients' attitudes to clinical research.

      Desmond, A; Stanton, A; Maher, V; Crean, P; Feely, J; Sullivan, P; Boehringer Ingelheim Ireland Ltd, Sandyford Business Estate, Dublin 18. audreydesmond@yahoo.co.uk (Irish medical journal, 2011-04)
      Every year hundreds of patients voluntarily participate in clinical trials across Ireland. However, little research has been done as to how patients find the experience. This survey was conducted in an attempt to ascertain clinical trial participants' views on their experience of participating in a clinical trial and to see and how clinical trial participation can be improved. One hundred and sixty-six clinical trial participants who had recently completed a global phase IV cardiovascular endpoint clinical trial were sent a 3-page questionnaire. Ninety-one (91%) respondents found the experience of participating in a clinical trial a good one with 85 (84.16%) respondents saying they would recommend participating in a clinical trial to a friend or relative and eighty-five (87.63%) respondents feeling they received better healthcare because they had participated in a clinical trial.
    • Survey of the management of acute asthma in children.

      Widger, J; Elnazir, B (Irish medical journal, 2009-12)
      Acute asthma is one of the most common reasons for children presenting to the emergency department. International guidelines for the management of acute paediatric asthma are widely available. In this study we examined how acute asthma in children is managed across hospitals in Ireland and compared Irish practice with standard international guidelines. We surveyed 54 paediatricians across 18 centres in Ireland. A total of 30 (55.5%) individual paediatricians across 17 (94%) centres replied. The majority of centres had a written protocol for the management of acute asthma. A large number of centres use MDI and spacer devices in acute management although doses used varied widely. Only 29% of centres had written asthma action plans available from the emergency department and 53% had plans available from the ward. Irish practice is largely inline with established guidelines. A national asthma strategy could further help to improve asthma care.
    • Understanding type 2 diabetes: including the family member's perspective.

      White, Patricia; Smith, Susan M; Hevey, David; O'Dowd, Thomas; Department of Public Health and Primary Care, Trinity College Centre for Health, Sciences, Adelaide and Meath Hospital incorporating the National Children's, Hospital, Tallaght, Dublin 24, Ireland. pwhite@tcd.ie (2012-02-01)
      PURPOSE: The purpose of this study was to examine the relationship between psychological and social factors and diabetes outcomes in people with type 2 diabetes and their family members. METHODS: A total of 153 patients with type 2 diabetes were assessed at a diabetes outpatient clinic and postal questionnaires were sent to nominated family members. The measures examined were diabetes knowledge, social support, well-being, and illness perceptions. RESULTS: When compared with those with diabetes, family members reported lower positive well-being and lower levels of satisfaction with support. They also perceived diabetes as a more cyclical illness, which was controlled more by treatment than by the individual. Family members also reported that the person with diabetes was more emotionally distressed and knew more about diabetes than the patient had actually reported himself or herself. There were no differences between the family members of those in good or poor glycaemic control. CONCLUSIONS: This study reinforces the importance of understanding social context and illness beliefs in diabetes management. It also highlights the potential for including family members in discussions and education about diabetes management.
    • Virtual reality rehabilitation of balance: assessment of the usability of the Nintendo Wii(®) Fit Plus.

      Meldrum, Dara; Glennon, Aine; Herdman, Susan; Murray, Deirdre; McConn-Walsh, Rory; Royal College of Surgeons in Ireland, School of Physiotherapy, Dublin, Ireland. dmeldrum@rcsi.ie (Disability and rehabilitation. Assistive technology, 2012-05)
      The aim of this study was to investigate the usability of the Nintendo Wii Fit Plus(®) (NWFP) in the treatment of balance impairment in vestibular and other neurological disease.